Is E-cigarette Smoking Dangerous?

Although E-cigarettes are touted as a safer alternative to traditional tobacco smoking, evidence proving this claim are limited.

What are E-Cigarettes?

An E-cigarette is an umbrella term for several electronic nicotine delivery systems (ENDs), which also include E-cigars, E-pens, and E-pipes. Since their introduction to the U.S. in 2007, ENDs have been promoted as safer alternatives to standard tobacco smoking, which claim the lives of over 480,000 people annually in the U.S1. Nevertheless, twelve states prohibit E-cigarette use in areas where smoking is also banned2.

E-cigarettes deliver nicotine through a vapor that resembles tobacco smoke, but with fewer of the toxic chemical byproducts of burning tobacco leaves. The vapor itself is produced from an E-liquid that contains nicotine mixed with a base like propylene glycol, flavorings, and other chemicals. Because E-cigarettes have only recently fallen under the regulatory oversight of the Food and Drug Administration (FDA)3, the exact composition of E-cigarette vapor is unknown. Some brands have tested positive for caustic chemicals like formaldehyde, benzene, and diacetyl. These could lead to complications like increase cancer risk, birth defects, and “popcorn lung”4.

Peer-reviewed studies of E-cigarette smoking are very limited, but seem to support the claim that E-cigarettes are benign. One study in 2012 concluded that chemical byproducts from E-cigarettes are not only significantly less toxic than those from tobacco smoke, but that E-cigarette byproducts produce no apparent risk to human health for all compounds analyzed5. A second study in 2013 showed that of 21 E-liquids examined, only one had cytotoxic effects on cultured fibroblasts6.

Despite these studies, the jury is still out on the safety of E-cigarettes. More scientific inquiries and clinical trials are needed for a definitive conclusion. Over 500 brands and 7,700 flavors of E-cigarettes are commercially available. Because there have been few regulations on E-cigarettes, E-liquids are likely to vary greatly between brands. Although some might be safe, others probably are not and should be removed from the market. Since E-cigarettes are newer products, there have yet to be studies on the long-term effects of E-cigarette smoking or secondhand emissions. Until these longitudinal studies are conducted, any evidence suggesting that E-cigarettes are safe are suggestive at best.

References:

  1. Smoking & Tobacco Use. Center for Disease Control and Prevention, 17 February 2016.
  1. States and Municipalities with Laws Regulating Use of Electronic Cigarettes, American Nonsmokers’ Rights Foundation, 1 October 2016.
  1. FDA Asserts Oversight Authority over Cigars, E-Cigarettes, Other Tobacco Products, 05 May 2016.
  1. Farsalinos KE, et al. Evaluation of electronic cigarette liquids and aerosol for the presence of selected inhalation toxins. Nicotine Tob Res. 2015; 17(2):168-74.
  1. McAuley, T.R. et al. Comparison of the effects of e-cigarettes vapor and cigarette smoke on air quality. Toxicol., 2012; 24(12):850-7.
  1. Romagna et al. Cytoxicity evaluation of electronic cigarette vapor extract on culture mammalian fibroblast (ClearStream-LIFE): comparison with tobacco cigarette smoke extract. Toxicol. 2013; 25(6):354-61.

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